资助模式对安大略省助产士整合的影响:一项定性研究
Elizabeth K Darling1,2, Sylvie B Lemay3,4, 'Remi Ejiwunmi3,5
1McMaster Midwifery Research Centre, McMaster University, 1280 Main St. West, HSC-4H26, Hamilton, ON, L8S 4K1, Canada. darlinek@mcmaster.ca.
BMC health services research
|October 11, 2023
概括
目前安大略省的助产士资助模式阻碍了最佳的整合. 灵活的薪酬和政策变化对于改善合作和扩大助产士的数量至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 助产士研究 助产士研究
背景情况:
- 加拿大安大略省的助产医生整合在合法化后近30年仍处于低于最佳状态.
- 资金模式是有效融入医疗保健系统中的助产士的主要障碍.
研究的目的:
- 检查产前,产后和产后资金安排对安大略省助产士整合的影响.
- 将最佳的助产一体化定义为充分利用助产士的技能,专业间的合作,以及在卫生系统中的归属感.
主要方法:
- 一个使用建设主义观点的定性描述性研究.
- 与助产士,产科医生,家庭医生和护士进行了半结构化的电话采访.
- 用专题分析来检查收集的数据.
主要成果:
- 基于护理过程的助产士资金支持客户满意度和结果,但缺乏灵活性,限制了跨专业的合作和对卫生系统差距的响应.
- 医生收费服务模式创造了竞争,限制了助产士的范围和医院接入,并不充分补偿了顾问.
- 孤立的助产士和医院资金阻碍了对社区医疗保健需求的创新贡献.
结论:
- 政策变化是必要的,以改善助产士的整合.
- 建议包括适当的顾问报酬 (可能是基于工资的医生资金) 和超出当前护理模式的助产士的灵活补偿.
- 一个明确的健康人力资源计划对于性和生殖保健是必不可少的.
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